Correlation of CD4/CD8 Ratio with Carotid Intima-Media Layer Thickness in HIV/AIDS Patients at Sanglah General Hospital, Bali, Indonesia

Abstract

BACKGROUND: The discovery of antiretroviral (ARV) drugs in 1996 led to a shift in the causes of mortality and morbidity of patients with HIV/AIDS. Initially, the cause of mortality and morbidity was associated with opportunistic infection HIV/AIDS-related complication, but now are more associated with non-AIDS complication such as cardiovascular disease. Atherosclerosis is a major cause of cardiovascular disease. The atherosclerosis was assessed by measuring carotid intima-media thickness (CIMT) using B mode ultrasound (USG), which is one of the diagnostic tools in indicating the presence of atherosclerotic plaque. AIM: This study aims to evaluate the ratio of CD4 / CD8 towards carotid intima-media thickness.METHODS: Design of study was analytic cross-sectional. This study was conducted in May – July 2017 in HIV patients who taken consecutively came to the VCT polyclinic of Sanglah hospital. Statistical analysis used Spearman correlation test to evaluate the correlation between the CD4/CD8 ratio and carotid intima-media thickness and multiple linear regression to predict carotid intima-media thickness through CD4/CD8 ratio.RESULTS: Total from 50 samples, data characteristic were 33 males (66%) and 17 females (34%), mean of age 30.60 ± 5.58 years, median of CD4/CD8 ratio 0.275 (0.02-1.39) and median of CIMT 0.75 (0.4-1.5) mm. There is a strong negative correlation (r = -0.85; p = 0.001) CD4/CD8 ratio with CIMT. The calculation of the prediction of carotid intima media thickness can be calculated through the equation Y = 0.727 -0.791 (X1) + 0.012 (X2), where X1 is CD4/CD8 ratio and X2 is the age of the patient.CONCLUSION: there is a significantly strong negative correlation between the CD4/CD8 ratio and CIMT in HIV patient who comes to VCT polyclinic of Sanglah Hospital. The smaller CD4/CD8 ratio, the value of CIMT will be thicker, and vice versa.